Neuroblastome Pelvien avec Extension Intra-Canalaire Mimant un Lipome chez une Enfant au Cameroun : Pelvic Neuroblastoma with Intraductal Extension Mimicking a Lipoma in a Child in Cameroon

Abstract

Neuroblastoma is the most common extracranial solid tumour in children. ‘Hourglass’-shaped intraductal extension is a rare but serious complication, causing spinal cord compression and neurological deficits. We report a case of pelvic neuroblastoma with intraspinal extension, initially misdiagnosed as a lipoma. A girl aged 3 years and 4 months presented with progressive functional weakness of the left lower limb, associated with a mass in the buttock region. An incomplete resection had been performed on suspicion of a lipoma, but this had not led to any clinical improvement. Computed tomography (CT) scan revealed a large, heterogeneous presacral pelvic mass, extending into the gluteal soft tissues and with tumour penetration through the enlarged intervertebral foramina, creating an hourglass appearance. This intraspinal extension was responsible for nerve compression, explaining the motor deficit. A diagnosis of locally advanced pelvic neuroblastoma with intraspinal extension was made. Multidisciplinary management was indicated, but the patient was lost to follow-up after the imaging report was received. This case illustrates the misleading presentation of a pelvic neuroblastoma, highlighting the need for systematic imaging in the presence of any soft-tissue mass associated with neurological deficit in children.